As dentists and dental technicians, you play an important role in helping our clients recover from their transport accident injuries.

We can pay the reasonable costs of dental treatment, without prior approval, when it is required as a result of a transport accident injury.

Diagnostic services, prosthodontics, periodontics, endodontics and other dental treatments are covered. Dental technician services are also covered, with some needing prior approval.

Dentists can also complete certificates of capacity to assess and certify your patient’s capacity for work. If your patient's accident was prior to 14th February 2018 they may need to meet the medical excess before you can invoice the TAC for treatment.

Click on the links below to see the full Dentist and Dental Technician guideline, to view the fee schedule and to find any documents and forms you may need.

Dental technician services needing prior approval:

Other things to note

Medical excess

For accidents that occurred prior to 14th February 2018 a medical excess may apply. Visit the medical excess page to see if it applies to your patient. If the medical excess applies you will need to invoice the client directly.

Certificate of capacity

As part of your patient’s treatment, dentists can also complete a certificate of capacity to assess and certify your patient’s capacity for work.

Patients with a severe injury

If your patient has a severe injury, the discussion, referral and approval of services may form part of the independence planning process between your patient's treating team and our TAC coordinator.

If your patient already has an individualised funding package, dental services may be included as part of that.

Replanting avulsed tooth and splinting

387, 772

$269.91

$382.00

Endodontics

Pulp capping

411

$32.49

$40.62

Cvek pulpotomy

414

$118.64

$173.47

Extirpation of pulp or debridement of root canal - 1 canal

415†

$216.13

$316.29

Extirpation of pulp or debridement of root canal - each additional canal

416

$96.37

$129.98

Root canal obturation - 1 canal

417†

$224.79

$323.60

Root canal obturation - each additional canal

418

$96.37

$129.98

Emergency endodontic procedure not exceeding 15 minutes

419

$121.75

$152.13

Apicectomy and apical seal

432, 434

$235.06

$312.50

Apexification - fee additional to routine endodontic treatment

458

$134.01

$210.62

Removal of root filling (per canal)

451

$88.96

$126.82

Additional visit for irrigation and/or dressing of the root canal system

455

$85.73

$103.79

† These fees include the cost of x-rays where required

Restorative Services

Metallic restoration - 1 surface

511

$101.79

$128.39

Metallic restoration - 2 surfaces

512

$121.74

$166.33

Metallic restoration - 3 surfaces

513

$144.35

$210.62

Adhesive resin restoration: anterior tooth - 1 surface

521

$111.63

$141.20

Adhesive resin restoration: anterior tooth - 2 surfaces

522

$131.85

$178.37

Adhesive resin restoration: anterior tooth - 3 surfaces

523

$152.13

$216.13

Adhesive resin restoration: anterior tooth - 4 surfaces

524

$183.85

$252.83

Adhesive resin restoration: posterior tooth - 1 surface

531

$117.70

$147.03

Adhesive resin restoration: posterior tooth - 2 surfaces

532

$141.95

$177.50

Adhesive resin restoration: posterior tooth - 3 surfaces

533

$170.37

$223.97

Metallic inlay or onlay - 2 surface cavity

542

$612.85

$739.45

Metallic inlay or onlay - 3 surface cavity

543

$720.39

$889.67

In the administration of the TAC's dental service the term "gold" shall be restricted to alloys with a gold content of not less than 40% and with total precious metal content in excess of 60%. Any other dental alloy will be classified as "non precious metal".

525/535

$281.06

$360.08

Temporary restoration emergency or interim treatment only

572

$95.15

$118.87

Pin retention (per unit pin)

575

$27.99

$27.99

Enamel bonded adhesive resin facing

582

$253.53

$316.83

Indirect bonded facing

583

$840.45

$1,065.86

Post - direct preformed

597

$95.15

$118.87

Temporary composite bridge when not part of definitive treatment (per pontic)

632

$198.01

$243.00

Crown and Bridgework

Bridges should be described in terms of the Australian Dental Association's Schedule of Dental Services. However, in addition to the number of units, the number of abutment teeth and pontics should be stated [eg 3 units (2+1). The fee which the TAC will consider reasonable may be calculated by
adding the fees listed for the restoration of the abutment teeth to the fees listed for the pontic or pontics as hereunder specified.

666

$1,559.77

Removal and reattachment of implant prosthesis for repair or cleaning

669

$158.44

Surgical implant guide

679

$216.13

$216.13

684

FBN*

$960.55

Osseo-integration procedure - one-stage

688

FBN*

$1,074.23

Osseo-integration procedure - fixation of transcutaneous abutment

691

FBN*

$363.46

If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from TAC.For the second and subsequent fixtures inserted at the same appointment, the multiple operation rule applies. In addition, the surgeon is entitled to reimbursement for the retail cost of any expendable implant hardware supplied directly.

Prosthodontics - Full Dentures

Full upper or full lower dentures

711, 712

$861.95

$1,283.98

Full upper and full lower dentures

719

$1,520.64

$2,391.48

Prosthodontics - Partial Dentures

Partial denture - acrylic base:

One tooth

721A/722A

$380.24

$475.27

Two teeth

721B/722B

$424.60

$530.68

Three teeth

721C/722C

$468.91

$587.67

Four teeth

721D/722D

$557.62

$697.01

Five to nine teeth

721E/722E

$646.35

$807.89

Ten teeth or more

721F/722F

$823.72

$1,029.69

Partial denture - chrome cobalt including cost of casting:

One or two teeth

727A/728A

$1,317.89

$1,647.35

Three or four teeth

727B/728B

$1,406.61

$1,758.20

Five to nine teeth

727C/728C

$1,520.64

$1,900.75

Ten teeth or more

727D/728D

$1,609.34

$2,011.64

Additional items for Acrylic Dentures only

Each retainer

731

$44.42

$44.42

Occlusal rest (not part of retainer)

732

$15.30

$15.30

Immediate tooth replacement

736

$10.29

$10.29

Full denture relining

743

$301.10

$376.45

Partial denture relining

744

$264.63

$329.57

Denture base modification

754

$153.58

$153.58

Adding tooth to partial denture to replace extracted tooth

768

$148.92

$148.92

Orthodontics

Active removable appliance therapy - one arch

821

$711.75

$1,028.35

Full arch banding - one arch

831

N/A

$3,722.40

Full course of fixed appliance orthodontic treatment

881

N/A

$5,805.32

Orthodontic extrusion of tooth

846

N/A

$844.54

Temporomandibular Joint Therapy

Full clinical assessment of case including joint and muscle palpation, occlusal analysis with study models and report to the TAC.

963, 964

$227.11

$278.60

Occlusal splint including initial programming

965

$515.42

$607.60

Routine adjustment of splint - per visit (maximum of 6 visits)

966

$85.68

$108.01

Travel - Treatment outside of rooms

FBN*

General

Specialist

Service Description

ADA Number

2016/2017 Maximum Payment Rate

2016/17 Maximum Payment Rate

Diagnostic services

Periodic oral examination

012

$47.22

$68.81

Initial examination and completion of TAC report form "DTF 1"

011, 018

$92.26

$114.02

Consultation arranged by the TAC for a second opinion, including a written report

Replanting avulsed tooth and splinting

387, 772

$265.97

$376.43

Endodontics

Pulp capping

411

$32.02

$40.03

Cvek pulpotomy

414

$116.91

$170.94

Extirpation of pulp or debridement of root canal - 1 canal

415†

$212.98

$311.68

Extirpation of pulp or debridement of root canal - each additional canal

416

$94.96

$128.08

Root canal obturation - 1 canal

417†

$221.51

$318.88

Root canal obturation - each additional canal

418

$94.96

$128.08

Emergency endodontic procedure not exceeding 15 minutes

419

$119.97

$149.91

Apicectomy and apical seal

432, 434

$231.63

$307.94

Apexification - fee additional to routine endodontic treatment

458

$132.06

$207.55

Removal of root filling (per canal)

451

$87.66

$124.97

Additional visit for irrigation and/or dressing of the root canal system

455

$84.48

$102.28

† These fees include the cost of x-rays where required

Restorative Services

Metallic restoration - 1 surface

511

$100.31

$126.52

Metallic restoration - 2 surfaces

512

$119.96

$163.90

Metallic restoration - 3 surfaces

513

$142.24

$207.55

Adhesive resin restoration: anterior tooth - 1 surface

521

$110.00

$139.14

Adhesive resin restoration: anterior tooth - 2 surfaces

522

$129.93

$175.77

Adhesive resin restoration: anterior tooth - 3 surfaces

523

$149.91

$212.98

Adhesive resin restoration: anterior tooth - 4 surfaces

524

$181.17

$249.14

Adhesive resin restoration: posterior tooth - 1 surface

531

$115.98

$144.89

Adhesive resin restoration: posterior tooth - 2 surfaces

532

$139.88

$174.91

Adhesive resin restoration: posterior tooth - 3 surfaces

533

$167.89

$220.70

Metallic inlay or onlay - 2 surface cavity

542

$603.91

$728.67

Metallic inlay or onlay - 3 surface cavity

543

$709.88

$876.69

In the administration of the TAC's dental service the term "gold" shall be restricted to alloys with a gold content of not less than 40% and with total precious metal content in excess of 60%. Any other dental alloy will be classified as "non precious metal".

525/535

$276.96

$354.83

Temporary restoration emergency or interim treatment only

572

$93.76

$117.14

Pin retention (per unit pin)

575

$27.58

$27.58

Enamel bonded adhesive resin facing

582

$249.83

$312.21

Indirect bonded facing

583

$828.19

$1,050.32

Post - direct preformed

597

$93.76

$117.14

Temporary composite bridge when not part of definitive treatment (per pontic)

632

$195.12

$239.46

Crown and Bridgework

Bridges should be described in terms of the Australian Dental Association's Schedule of Dental Services. However, in addition to the number of units, the number of abutment teeth and pontics should be stated [eg 3 units (2+1). The fee which the TAC will consider reasonable may be calculated by
adding the fees listed for the restoration of the abutment teeth to the fees listed for the pontic or pontics as hereunder specified.

666

$1,537.02

Removal and reattachment of implant prosthesis for repair or cleaning

669

$156.13

Surgical implant guide

679

$212.98

$212.98

684

FBN*

$946.54

Osseo-integration procedure - one-stage

688

FBN*

$1,058.56

Osseo-integration procedure - fixation of transcutaneous abutment

691

FBN*

$358.16

If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from TAC.For the second and subsequent fixtures inserted at the same appointment, the multiple operation rule applies. In addition, the surgeon is entitled to reimbursement for the retail cost of any expendable implant hardware supplied directly.

Prosthodontics - Full Dentures

Full upper or full lower dentures

711, 712

$849.38

$1,265.25

Full upper and full lower dentures

719

$1,498.46

$2,356.60

Prosthodontics - Partial Dentures

Partial denture - acrylic base:

One tooth

721A/722A

$374.69

$468.34

Two teeth

721B/722B

$418.41

$522.94

Three teeth

721C/722C

$462.07

$579.10

Four teeth

721D/722D

$549.49

$686.84

Five to nine teeth

721E/722E

$636.92

$796.11

Ten teeth or more

721F/722F

$811.71

$1,014.67

Partial denture - chrome cobalt including cost of casting:

One or two teeth

727A/728A

$1,298.67

$1,623.32

Three or four teeth

727B/728B

$1,386.10

$1,732.56

Five to nine teeth

727C/728C

$1,498.46

$1,873.03

Ten teeth or more

727D/728D

$1,585.87

$1,982.30

Additional items for Acrylic Dentures only

Each retainer

731

$43.77

$43.77

Occlusal rest (not part of retainer)

732

$15.08

$15.08

Immediate tooth replacement

736

$10.14

$10.14

Full denture relining

743

$296.71

$370.96

Partial denture relining

744

$260.77

$324.76

Denture base modification

754

$151.34

$151.34

Adding tooth to partial denture to replace extracted tooth

768

$146.75

$146.75

Orthodontics

Active removable appliance therapy - one arch

821

$701.37

$1,013.35

Full arch banding - one arch

831

N/A

$3,668.11

Full course of fixed appliance orthodontic treatment

881

N/A

$5,720.65

Orthodontic extrusion of tooth

846

N/A

$832.22

Temporomandibular Joint Therapy

Full clinical assessment of case including joint and muscle palpation, occlusal analysis with study models and report to the TAC.

963, 964

$223.80

$274.54

Occlusal splint including initial programming

965

$507.90

$598.74

Routine adjustment of splint - per visit (maximum of 6 visits)

966

$84.43

$106.43

Travel - Treatment outside of rooms

FBN*

* Note: Where the terminology FBN appears in this schedule, the fee must be negotiated with the TAC before any dental treatment is commenced.

GST

*The TAC maximum fee includes a 10% allowance for GST for items which TAC believes are taxable supplies. If you are a provider not registered for GST:

You are not legally permitted to charge GST

You should indicate on all invoices submitted your status as 'not registered for GST purposes'

The TAC will only reimburse you an amount which excludes the GST component for items billed where the maximum fee includes a 10% allowance for GST

If you are not registered for GST please state on all invoices the TAC item number listed for providers not registered.

Medical Services Reimbursement Rates

The TAC has adopted the Medicare Benefits Schedule (MBS) items, explanations, definitions, rules and conditions for services provided by medical practitioners. When invoicing for medical services, medical practitioners are expected to adhere to the MBS rules unless otherwise specified by the TAC in the Reimbursement Rates for Medical Services booklet or its medical policies.

The Reimbursement Rates for Medical Services booklet below must be read in conjunction with:

At the time of production this publication contained up to date information as released by Medicare Australia (Medicare). The relevant publication will be updated to reflect any further changes that are implemented by Medicare each year. Please check our website for the latest version.

If you have any questions about these publications or the reimbursement rates, please contact the TAC on 1300 654 329. Alternatively, e-mail info@tac.vic.gov.au.

Forms and brochures

View Dental: dental report form

Dental: dental report form

Summary:

This form is for dental treatment providers to report damage caused to a client's teeth and mouth as a result of their accident and propose a treatment plan.

How to register as a provider

During the registration process you may be asked to provide evidence of your qualification or other documentation requested by us.

What we can pay for

Approved services

The following services are approved for all our clients:

ambulance

hospital (including surgery for the first three months from the date of accident)

medical (including medical imaging)

pharmacy

allied health

mental health

domestic services and gardening

interpreting services

equipment under $1,000

We do not require requests, clinical notes or reports before we will pay for the above services.

Other services

We must approve in writing any services not listed above.

Requests for approval must be in writing from an appropriately qualified health professional and include the following information:

claim number

transport accident injury being treated

type of treatment or service being requested

rationale as to why it is required

proposed date of the service/treatment

number of services proposed or expected duration

date treatment will be reviewed

functional goals/outcome measure that will be used to evaluate the treatment

self-management strategies in place

We will consider the principles of the Clinical Framework when considering whether a treatment or service request is reasonable and appropriate. We will then respond to written treatment and service requests as set out in our TAC Service Charter.

Travel

We can pay the reasonable cost of travel without prior approval where:

It is clinically justified for you to conduct treatment in the community, or you are the most appropriate option in that locality, and

Medical excess (applies to accidents before 14th February 2018)

Client's whose accidents occurred prior to 14th February 2018 are required to pay the first $629 of treatment costs for medical services (excluding hospital and ambulance) before the TAC can fund their ongoing treatment unless:

the client or an immediate family member were admitted to hospital as an inpatient; or

an immediate family member dies as a result of the transport accident.

If a TAC client hasn't reached the medical excess, you need to invoice them directly for any medical treatment and services they receive. Bulk billed services can be used to reach the medical excess amount.

Once the client has provided a declaration to the TAC that they have reached their medical excess, you can begin invoicing the TAC directly.

When further information is needed

In some cases we may contact your patient or yourself to seek further information about the treatment or service. We will send in writing any requests for reports or information.

We can release a treatment report to the client, another health practitioner or the client's legal representative upon receipt of a verbal or written request from a client or their legal representative.

Subsequent, pre-existing and non-accident related injuries

Notify us if your patient has sustained a subsequent or exacerbation of an existing injury.

Where a pre-existing injury has become aggravated as a result of a transport accident, we will fund treatment for the exacerbation of that injury.

When a patient is being treated for non-accident related injuries at the same time as accident related injuries, you may only invoice us for the treatment relating to the patient’s accident related injury.

We will only accept liability for an injury sustained after the transport accident if it is established that a patient’s subsequent injury is a direct result of the injury or injuries originally sustained in the transport accident.

Treatment by an immediate family member

We cannot pay for treatment or services provided by a member of a client’s immediate family, unless exceptional circumstances exist such as:

Treatment was provided in an emergency situation.

A client resides in a remote area and the distance to access an alternative health care professional is excessive.

When the TAC client has been treated by a family member, care should be transferred to another suitably qualified healthcare professional as soon as practicable.

If multiple providers are required on one invoice, you must clearly identify the service listed under each service provider. Duplicate accounts, such as statements, photocopies or facsimiles will not be processed for payment.

Send your invoice to:

Transport Accident Commission (TAC) GPO Box 2751 MELBOURNE VIC 3001

Payment dates

We process invoices each week. Payment will be made to your bank account.

Invoices you submit to us should accurately reflect the goods and/or services that have been provided. Inaccurate, inappropriate or fraudulent invoicing may result in requests for supporting documentation, prosecution, recovery of inappropriately paid funds or other actions.

If you become aware of an error in your invoicing for services provided to our clients, or where there is a concern over the accuracy of the payments that we have made, contact us on 1300 654 329 to rectify the situation.

What we cannot pay for

Services

We cannot pay for:

Services for a person other than the client (except for family counselling where applicable).

Expenses and travel

We cannot pay for:

The cost of telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals. The exception is GPs coordinating return to work programs approved by us.

Downtime between appointments or travel expenses unrelated to a consultation.